1. Field of the Invention
The invention relates to a stimulating apparatus for preventing urinary incontinence which applies electrical or magnetic stimulation to a patient suffering from urinary incontinence, and which records the progress of stimulation.
2. Related Art
Generally, it is known that electrical stimulation is effective for prevention or treatment of various kinds of urinary incontinence such as stress incontinence, urge incontinence, and mixed incontinence.
In the prior art, for example, such electrical stimulation is conducted in the following manner. First, surface electrodes are attached to the body surface in the vicinity of the pudendum of the patient; an electrode plug is inserted into the anus, the vagina, or the like; or electrodes are directly embedded into the pelvic floor muscle or the vicinity of the pudendum. Then, electrical stimulation is repeatedly applied at a frequency of several to 100 Hz. This stimulation treatment is continued for one week to several months. The intensity and frequency of electrical stimulation, the stimulation period, the stimulation region, and the like depend on cases and individual differences.
In the treatment with electrical stimulation, specifically, the patient goes to the hospital once each week for several months to be treated with stimulation for 15 to 30 minutes, or, in accordance with instructions of the doctor, the patient is subjected at home two or three times a day to stimulation for about 20 minutes by using a portable electric stimulating apparatus. The patient is provided with a patient diary and instructed to record in detail voiding conditions in daily life, such as the stimulation period, the stimulation intensity, the time of incontinence, the time of voiding, the time of exchange of a diaper or underpants, and the degree of the urge sensation. After a predetermined period elapses, the doctor reads the patient's diary to judge whether the present treatment is effective or not, and decides the subsequent treatment policy.
A test is provided in order to determine the effect of the electrical stimulation treatment. The test may include a urodynamic study (UDS) in which a catheter is inserted into the urethra and the urethral sphincter is pricked with a needle electrode; a test using an ultrasonic diagnostic apparatus; or a pad test in which a stress incontinent patient is given water and then made to take various kinds of bodily exercises at predetermined intervals, and the degree of urinary incontinence is checked. Usually, these tests are used for diagnosis of the type of urinary incontinence, or to check of the presence or absence of voiding disfunction, and hence must be performed by a specialist. Furthermore, inspection apparatuses used in these tests are so expensive that not all hospitals are equipped with such apparatuses.
Regarding the effect of stimulation, the occurrence of urinary incontinence and voiding for each individual is compared with the initial state on the basis of the patient diary, and it is judged whether a change occurred or not. Usually, it is known that, if electrical stimulation is effective, the frequency of urinary incontinence or the like is reduced. However, there are differences among individuals , and hence the judgment cannot be uniformly applied. Practically, therefore, the treatment effect depends on the recording accuracy of the patient diary.
In the treatment of urinary incontinence with electrical stimulation, it is important to know the reason why the treatment is not working, i.e., an effect is not attained although stimulation has been conducted at an appropriate intensity and for a predetermined period, or, even though the patient has conducted stimulation in accordance with instructions of the doctor, an effect is not attained because of insufficient stimulation intensity and stimulation number. In accordance with the result, the subsequent treatment policy is determined.
With respect to a treatment effect, furthermore, the subjective symptom of the patient does not always coincide with the result of the test conducted by the doctor. Even in the case where an unfavorable test result is obtained, when the occurrence of urinary incontinence and voiding are reduced, the patient believes the treatment has worked, with the result that the quality of life (QOL) is improved. Under such circumstances, a patient diary which is used in the prior art is very significant to both the patient and the doctor.
However, aged persons constitute a large portion of urinary incontinent patients, and hence it is difficult to record information in a patient diary, as instructed, for a long term without omission. Furthermore, it is difficult to ask the caregiver to record all items of information because there may arise a problem of privacy.
In the prior art treatment, a UDS test or a pad test is conducted in order to judge the treatment effect. The UDS has a drawback that it has a high degree of invasivenss and inflicts pain on the patient. The pad test is free from invasiveness but compels the patient to take special exercises for predetermined periods. In other words, both the tests are conducted under an unnatural state, and hence cannot obtain a correct state of the symptom.
In the case of an outing or travel, moreover, the patient must always carry the diary together with an electric stimulating apparatus and record information in the diary. This is cumbersome work.